【摘要】：[目的]探究中緬邊境地區(qū)克欽青少年瘧疾蠕蟲混合感染情況及G6PD缺乏癥情況。[方法]實驗分為現(xiàn)場樣本收集和實驗檢測兩部分,現(xiàn)場樣本收集主要是收集中緬邊境兩所學校學生的糞便及指血樣本。實驗室中將收集的糞便標本采用改良加藤法對每份糞便樣本進行“一糞三檢”,經(jīng)鏡檢確定寄生蟲蟲卵類型并且對各種蟲卵分別進行計數(shù),指血分別用來PCR鑒定瘧疾感染類型以確定瘧疾亞微觀感染,G6PD缺乏癥測定及血紅蛋白測定。[結果]1.對云南中緬邊境地區(qū)L1與N2兩所學校學生共1032例樣本進行直接濾紙血PCR鑒定,得出間日瘧33例,惡性瘧8例。鏡檢瘧原蟲發(fā)現(xiàn)間日瘧18例。直接濾紙血IPCR方法檢測瘧原蟲感染的檢出率高于傳統(tǒng)鏡檢方法(間日瘧：p=0.03,χ2=4.52,惡性瘧：p=0.005,f=8.03)2.對這1032例樣本利用改良加藤法診斷糞便蠕蟲后我們發(fā)現(xiàn)鉤蟲感染率為最高(31.30%),蛔蟲(1.36%)、蟯蟲(1.16%)、鞭蟲(0.29%)列為其后。其中除發(fā)現(xiàn)瘧原蟲與鉤蟲共同感染外,未見與其他蠕蟲的共同感染。3.對不同年齡段學生進行分組,經(jīng)過數(shù)據(jù)統(tǒng)計分析,我們發(fā)現(xiàn)鉤蟲感染率在高年齡組明顯高于低年齡組(p0.001),鞭蟲的感染率在高年齡組也明顯高于低年齡組(p=0.04)。其中瘧原蟲與鉤蟲合并感染占總瘧原蟲感染人數(shù)的36.59%。4.調查地區(qū)女性蠕蟲和瘧原蟲感染率均稍高于同齡男性,但是并沒有統(tǒng)計學意義。5.發(fā)現(xiàn)貧血與G6PD缺乏癥相關(p=0.047),與蠕蟲感染也有關(p=0.01),與鉤蟲關系最為明顯(p=0.02)。不同程度的貧血與G6PD缺乏癥、蠕蟲和瘧原蟲的關系不顯著。6.參與調查的L1與N2學校學生相比而言,N2學校學生蠕蟲和瘧原蟲感染率較高,其中蠕蟲感染率顯著高于L1學校學生(p0.001),且血紅蛋白和BMI水平顯著N2學校學生低于L1(p0.001)。[結論]1.直接濾紙血PCR方法檢測瘧原蟲類型與傳統(tǒng)鏡檢方法相比有明顯優(yōu)勢且與傳統(tǒng)DNA提取后進行PCR相比,節(jié)省資金和時間,值得推廣使用。2.對不同年齡段青少年分組進行分析后得出高年齡組鉤蟲及鞭蟲感染顯著高于低年齡組�？傮w來看高年齡組歲組寄生蟲感染率均較高,但其他感染無統(tǒng)計學差異。3.發(fā)現(xiàn)貧血與G6PD缺乏癥有關系顯著,與蠕蟲感染也有顯著關系,其中與鉤蟲關系最為明顯。4.參與調查的N2學校學生蠕蟲感染率明顯高于L1學校,血紅蛋白水平N2學校學生明顯低于L1學校, N2學校學生BMI也明顯低于L1學校。
[Abstract]:Objective: to investigate the mixed infection of malaria worm and G6PD deficiency in Kachin adolescents in the border area of China and Myanmar. [methods] the experiment is divided into two parts: field sample collection and experimental examination. The collection of field samples mainly consists of collecting feces and finger blood samples of students in two schools along the border between China and Myanmar. The fecal specimens collected in the laboratory were collected by modified Kato method to carry out "one fecal triple examination" for each fecal sample. The type of parasite eggs was determined by microscopic examination and the eggs were counted separately. Finger blood was used to identify the type of malaria infection by PCR in order to determine submicroscopic malaria infection, G6PD deficiency and hemoglobin determination. [result] 1. A total of 1032 samples from L _ 1 and N _ 2 schools in the border area of China and Myanmar in Yunnan Province were identified by direct filter paper blood PCR. 33 cases of vivax malaria and 8 cases of falciparum malaria were obtained. 18 cases of Plasmodium vivax were detected by microscope. The detection rate of Plasmodium falciparum infection by direct filter paper blood IPCR method was higher than that by traditional microscopic method (vivax malaria: p0. 03, 蠂 2: 4. 52, falciparum malaria: p0. 005 FU 8. 03) 2. The infection rate of hookworm (31.30%), Ascaris (1.36%), Enterobius vermicularis (1.16%) and Trichuris (0.29%) were found to be the highest (31.30%). Except for the co-infection of Plasmodium and hookworm, there was no co-infection with other worms. According to the statistical analysis, we found that the infection rate of hookworm in the high age group was significantly higher than that in the low age group (p0.001), and the infection rate of Trichuris in the high age group was significantly higher than that in the low age group (p0. 04). Among them, the co-infection of Plasmodium and hookworm accounted for 36.59.4. The infection rates of female worms and malaria parasites were slightly higher than those of men of the same age, but there was no statistically significant difference between them. It was found that anemia was associated with G6PD deficiency (p0. 047), worm infection (p0. 01), and hookworm (p0. 02). The relationship between anemia and G6PD deficiency, worm and malaria parasite was not significant. 6. 6%. The infection rate of worm and malaria parasite in N2 school was higher than that in L1 school (p0.001). The levels of hemoglobin and BMI were significantly lower in N 2 school than in L 1 (p 0. 001). [conclusion] 1. The direct filter paper blood PCR method has obvious advantages compared with the traditional microscopic method in detecting Plasmodium parasites. Compared with the traditional DNA extraction method, it saves money and time, and is worth popularizing. 2. The analysis of different age groups showed that the infection of hookworm and Trichuris in the high age group was significantly higher than that in the low age group. In general, the parasite infection rate was higher in the age group, but there was no significant difference in other infections. It was found that anemia had a significant relationship with G6PD deficiency and worm infection, especially hookworm. The infection rate of helminth in N2 school was significantly higher than that in L1 school, the hemoglobin level in N2 school was significantly lower than that in L1 school, and the BMI in N2 school was significantly lower than that in L1 school.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R531.3;R532

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